Recurrence of Bile Duct Stones after Endoscopic Papillary Large Balloon Dilation Combined with Limited Sphincterotomy: Long-Term Follow-Up Study.
- Author:
Kook Hyun KIM
1
;
Jung Hyun RHU
;
Tae Nyeun KIM
Author Information
1. Department of Internal Medicine, CHA Gumi Medical Center, CHA University, Gumi, Korea. tnk@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Endoscopic sphincterotomy;
Endoscopic papillary large balloon dilation;
Common bile duct stone
- MeSH:
Bile;
Bile Ducts;
Common Bile Duct;
Follow-Up Studies;
Humans;
Multivariate Analysis;
Odds Ratio;
Recurrence;
Retrospective Studies;
Risk Factors;
Sphincterotomy, Endoscopic
- From:Gut and Liver
2012;6(1):107-112
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Endoscopic papillary large-balloon dilation combined with limited endoscopic sphincterotomy (EPLBD+ES) is promising for the treatment of common bile duct (CBD) stones. The aim of this study was to clarify the recurrence rate and the risk factors for CBD stones after EPLBD+ES. METHODS: In total, 100 patients who underwent EPLBD+ES from 2006 to 2007 were evaluated retrospectively. One hundred and nine patients who were treated with endoscopic sphincterotomy (ES) from 2004 to 2005 were set as the historical control group. Various risk factors for the recurrence of bile duct stones were analyzed. RESULTS: Of the 209 patients, the duration of follow-up was 32.5+/-4.5 months in the EPLBD+ES group and 31.8+/-6.0 months in the ES group. The recurrence rate of CBD stones was 11.0% (11/100) in the EPLBD+ES group and 13.8% (15/109) in the ES group (p=0.546). The cumulative recurrence rate of stones was not significantly different between the EPLBD+ES and ES groups (log rank, p=0.537). Univariate analysis showed that the diameter of the CBD (> or =22 mm) was the only predictive variable that could differentiate recurrence from nonrecurrence in the EPLBD+ES group. Multivariate analysis revealed that the diameter of the bile duct was the only risk factor for stone recurrence (p=0.022; odds ratio, 1.175; 95% confidence interval, 1.023 to 1.348). CONCLUSIONS: The recurrence rate of CBD stones after EPLBD+ES is comparable to that of the ES group, and a dilated CBD appears to increase the risk of bile duct stone recurrence.
